OBJECTIVE To discuss and focus on the hospital infection management in the secondary care and over level hospitals,and the effective control of nosocomial infection.METHODS For the problems and hidden drisks,were targeted to take a scientific and effective prevention and control measures to strengthen the management of the details.RESULTS By changing the concept of process-oriented monitoring,training and scientific management the nosocomial infection effectively controlled.CONCLUSIONS Only the standardized management and operations,security checks and routine testing can be a real focus on hospital infection management.

Objective To compare the efficacy and adverse reactions between floxuridine (FUDR) and 5-fluorouracil (5-Fu) treatment of gestational trophoblastic tumor.Methods 111 trophoblastic tumor patients of Ⅱ-Ⅲ stage including 62 cases of in vasive mole and 49 cases of choriocarcinoma were analyzed retrospectinely.The patients were divided into FUDR+KSM group (55 cases) and 5-Fu+KSM group (56 cases).FUDR was according to 23 mg/kg·d phleb instillation,keeping 8 hours,KSM was according to 6 μg/kg·d phleb instillation,keeping 4 hours.5-Fu was according to 26 mg/kg·d phleb instillation,keeping 8 hours.KSM was according to 6 μg/kg·d phleb instillation,keeping 4 hours.Both the two programs were 8 days.Results The cure rate was 98 ％ (54/55) in FUDR+DSM group,and that was 96 ％ (54/56) in 5-Fu+KSM group.The incidence rates of phlebophlogosis,dental ulcer and alopecie in the FUDR+KSM group were obviously lower than those in 5-Fu+KSM group [29.1％ (16/55) vs 85.7 ％ (48/56),54.5 ％ (30/55) vs 98.2 ％(55/56),21.8 ％ (12/55) vs 89.3 ％ (50/56),all P ＜ 0.05].Both the FUDR+KSM group and the 5-Fu+KSM group bad significant differences at phlebophlogosis dental ulcer and alopecie in Ⅲ stages.Conclusion The curative effect of the FUDR is aimilar with the 5-Fu,but the drug consumption of the FUDR is less.The incidence rates of dental ulcer,alopecie,and phlebophlogosis are less,but myelosuppression and alvi profluvium are rcscmble between the two sets.

Objective To evaluate the effect of nasal continuous positive airway pressure (nCPAP) in pediatric patients with respiratory failure after liver transplantation.Method A prospective? randomized controlled clinical trial was conducted during June 1st 2013 to June lst2015 in 71 pediatric patients with respiratory failure after liver transplantation.A total of 66 patients completed the trial and 5 patients quitted.Conventional oxygen therapy group included 35 cases and nCPAP group included 31 cases.The vital sign,blood-gas analysis,intra-abdominal pressure and prognosis were compared between the two groups.Result After nCPAP treatment,the heart rate,respiratory rate,and PCO2 decreased at 4 and 24 h (P＜0.05),oxygenation index was improved at 24 and 48 h (P＜0.05),and intra-abdominal pressure decreased at 48 h (P＜0.05).nCPAP showed better outcome than conventional oxygen therapy (P＜0.05).The incidence of refractory atelectasis,intra-abdominal hypertension,and epilepsy was higher in treatment failure population.Conclusion nCPAP is more suitable for pediatric patients with respiratory failure after liver transplantation,especially for those accompanied with intra-abdominal hypertension.

With the understanding of the function mechanism of RNAi,it has been widely applied in various fields.RNAi is a powerful tool to study gene functions and provides a new technical method for the specific gene treatment as well.The further development of RNAi technique opens up a new way for tumor gene treatment.

OBJECTIVE To discuss the disinfection effect of Laoken KDSJ-Y multi-purpose air disinfecting machine using in the newborn hospital ward for air sterilization.METHODS Standard sample were carried on separately before starting,the starting 60 minutes later,the engine off latter 60 minutes and 120 minutes,after raising and the bacteria number were calculated.RESULTS Dynamic disinfection in room temperature 30-31℃,humidity 68-72%.Room population 10.7,and does not limit in the undertake transfer of personnel situation,starting disinfects 60 minutes to be able to achieveⅡ The kind of disinfection ambient air contains the fungus quantity standard;After before starting disinfection,and engine off,colony quantity continues to increase,cannot achieve toⅡ The kind of disinfection ambient air including the fungus quantity request after 120 minutes,must starting disinfect once more.CONCLUSIONS Laoken KDSJ-Y multi-purpose air disinfecting machine under some person of conditions the dynamic disinfection to be possible in the control air the bacterial content,conforms to the newborn hospital ward 2 kind of ambient air disinfection sanitation standard,suits the promotion.

OBJECTIVE To explore the distribution,bacterial types and antibiotic-resistance in a children hospital.METHODS The methods of combining objective investigation with the(doctor′s) report were adopted.RESULTS In our hospital,the rate of upper airway infections was in the first accounted for 42.4%,mainly ocourred in internal neurology,hematology and nephrology departments and gastrointestinal and cardiosurgery departments.(Among) Gram-negative robs,Pseudomonas aeruginosa was the principle of the upper airway infections,it was(sensitive) to ceftazidime.Among Gram-positive cocci,the Staphylococcus aureus and Enteroccoccus were the main pathogens concerned, which were(sensitive) to vancomycin and nitrofurantoin.CONCLUSIONS Long-hospitalization,unreasonable use of hormone and(antibiotic).invasive operation and various diseases in the same department are the main risk factors,for the correspondent(measures) must apply to prevent and control the hospital infection.

OBJECTIVE To inspect the condition of hands-washing among medical staff in order to improve it accordingly.METHODS Direct inspection on the effect of hands-washing among medical staff from all departments within hospital at a fixed interval and make statistics as well as analysis retrospectively.RESULTS The qualified rate of hands-washing respectively was 90.03%,91.47%,91.54%,and 93.55% during the years of 2003 through 2006.The rate had risen steadily.The qualified rate of hands-washing in key departmeuts and in others was 89.15% and 87.87%.respectively,without significatnt differences.However,the qualified rate among nurses and doctors was 93.80% and 87.17%,respectively.The qualified rate among nurses was obviousely higher than among doctors in this regard with significant differences between them.CONCLUSIONS Intensifying training and standardizing hands-washing methods by means of choosing suitable hands-detergents are important in order to improve the compliance of hands-washing among medical staff.

Objective To evaluate the parenteral complications and their risk factors and to study the immune status by detecting immunoglobulin and lymphocyte subsets in children with rotavirus enteritis. Methods Sixty-four children with rotavirus enteritis who were treated in Shengjing Hospital of China Medical University between January 2007 and December 2008(observation group) and 18 healthy chiIdren for health screening at pediatric health care center (normal control group) were reeruimd.Clinical manifestations were collected,stool specimens were detected for rotavirus using ELISA,lymphocyte subsets were detected using flow cytometer,and immunoglobulin.liver enzyme and myocardial enzyme were detected.Results Rotavirus enteritis may be complicated by parenteral complications(liver,myocardium,respiratory and nervous system).The activity of ALT,AST,LDH,CK and CK-mB were higher in observation group than that in normal control group(P<0.05).In observation group,liver injury rate in children younger than 12 months was higher than that in children older than 12 months,and the activity of CK and CK-mB were highcr in severe diarrhea cases[CK(324.5±995.5)U／dl,CK-mB(93.8 4±61.5)U／dl]than that in mild diarrhea cases [CK(252.8±130.4)U／dl,CK.mB(59.6±32.6)U／dl](P<0.05).The level of IgG was lower in observation group[(4.46±1.56)g／L]than that in control group[(5.80±1.67)g／L](P<0.05).Lymphocytes subsets study revealed that the activity of CD4+ in observation group[(29.0±4.18)％]was lower than that in control group[(38.6±3.97)％](P<0.05),the activity of CDl9+ [(38.8±3.94)％]was higher than that in control group[(23.1±7.70)％](P<0.05)and the CD4+／CD8+ ratio was reverse in observafion group.Conclusion Rotavirus enteritis may be complicated by parenteral injuries which get liver,myocardium,respiratory and nervous system involved.Children with rotavirus enteritis Call lead to low immune function.Determination of liver enzyme,myocardial enzyme,immunoglobulin and lymphocyte subsets has important clinical significance to monitoring the change of condition and guiding treatment.

Objective To investigate the effect of different pharmacotherapy after lacrimal passage plastic laser operation. Methods Divided 90 patients (103 eyes) with nasolacrimal duct obstruction into group A (33 eyes), group B (36 eyes) and group C (34 eyes) randomly, each group consisted of 30 cases. Tetracycline cortisone ophthalmic ointment (TCO) was used to perfuse lacrimal duct in the end of the operation in group A, while TDO was used in group B and group C. In the first three postoperative irrigation, TDO was used only in group C, there are no no ointment during the course of irrigation in the other two groups. Followed-up survey for 3 months, evaluated the efficacy of the treatment in 3 groups. Results The therapeutic efficacy was significant better in group B than in group A (P

Objective To compare the effects of sedation induced with midazolam and propofol on blood pressure(BP), heart rate(HR) and heart rate variability (HRV) during operation on lower extremity preformed under continuous epidural anesthesia in patients with the type Ⅱ diabetes. Methods Forty patients with type Ⅱ diabetes scheduled for lower limb surgery were randomized to receive either midazolam (group M n - 20) for propofol (group P n = 20) for sedation during operation, all patients were classified as ASA physical status Ⅱ or Ⅲ . The patients were unpremeditated. Epidural catheter was inserted at L2-3 or L3-4 . The local anesthetic used was 2% lidocaine. MAP,HR,HRV and SpO2 were monitored during anesthesia and operation. After onset of epidural analgesia a loading dose of midazolam(0.03 mg?kg-1 ) or propofol (0.7 mg?kg-1 ) was given i.v. followed by intermittent i.v. boluses of 1 /4-1 /2 loading dose to maintain the depth of sedation at OAA/S score of 3 (respond to name outer if called repeatedly) . Changes in HRV before and during sedation were recorded and compared between the two groups. Results The demographic data including sex, age and body weight were comparable between the two groups. LF and TP decreased significantly during sedation as compared with baseline in both groups ( P